Bacterial vaginosis (BV) is a common vaginal condition caused by an imbalance of bacteria. Affecting millions of women globally, it is the most frequent vaginal problem for individuals aged 15 to 44. This article explores its causes, particularly the involvement of male partners.
Understanding Bacterial Vaginosis
Bacterial vaginosis (BV) involves an overgrowth of certain vaginal bacteria, disrupting the normal balance of beneficial lactobacilli. While not a sexually transmitted infection (STI), sexual activity can influence its occurrence. A healthy vaginal microbiome is typically dominated by Lactobacillus species, which produce lactic acid to maintain an acidic environment (pH between 3.8 and 4.5), inhibiting harmful microorganisms.
When this delicate balance is disturbed, anaerobic bacteria, such as Gardnerella vaginalis, can multiply excessively. This bacterial shift often leads to symptoms like a thin, off-white, gray, or greenish vaginal discharge and a distinct “fishy” odor, which may become more noticeable after sex. Other symptoms include vaginal itching or irritation and a burning sensation during urination. Many individuals with BV, however, experience no symptoms at all.
How Male Partners Influence BV Risk
Men do not contract BV as they lack a vagina and cannot directly transmit the infection like STIs. However, sexual activity with male partners can influence the vaginal environment and increase a woman’s BV risk. Semen is alkaline, and its introduction can temporarily raise the vaginal pH, creating a less acidic environment that favors the growth of BV-associated bacteria.
The exchange of bacteria during sexual activity with a male partner can also disrupt the vaginal microbiome. Even if these bacteria are not pathogenic for the man, their presence can alter the delicate balance of microorganisms in the vagina. The frequency of sexual activity and the number of partners a woman has are also considered indirect risk factors, as they increase exposure to factors that can disturb the vaginal environment. Recent research suggests a “partner effect” or “shared microbiome,” where treating male partners with antibiotics can significantly reduce BV recurrence in women.
Other Factors Contributing to BV
Douching involves rinsing the vagina with water or other solutions, which can disrupt the natural pH and beneficial bacterial balance. Studies show regular douching increases BV risk by disturbing the vaginal flora.
Certain intrauterine devices (IUDs), particularly copper IUDs, are associated with an increased BV risk. Some studies indicate copper IUD users may experience a higher incidence of BV compared to those using no contraception or other non-hormonal methods. A lack of naturally occurring Lactobacillus species also predisposes individuals to BV, as these beneficial bacteria are crucial for maintaining vaginal health. Hormonal changes during menstruation, pregnancy, or menopause can also influence the vaginal microbiome and contribute to BV risk by affecting Lactobacillus levels. Genetic predisposition might also contribute to susceptibility.
Partner Considerations in BV Management
Male partners generally do not require BV treatment, as they do not develop the condition themselves. However, recent studies suggest that treating male partners may help reduce BV recurrence in women. This approach, involving both the woman and her male partner receiving specific antibiotic treatments, has shown promising results in reducing BV recurrence rates.
Open communication between partners about vaginal health is helpful for managing BV. Consistent and correct condom use can help prevent BV occurrence, particularly in women who are BV-negative, by reducing the exchange of factors that disrupt the vaginal environment. Practicing good hygiene, such as washing before and after sexual activity, can also contribute to reducing risk. It is important for women to seek medical advice for BV symptoms and complete any prescribed treatment, regardless of partner involvement, to prevent potential complications like pelvic inflammatory disease or increased susceptibility to STIs.